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Home-based provider QUESTIONNAIRE WITH SCREENER (listed home-based providers)
National Survey of Early Care and Education (NSECE): The Household, Provider, and Workforce Surveys
OMB: 0970-0391
IC ID: 232741
OMB.report
HHS/ACF
OMB 0970-0391
ICR 201905-0970-010
IC 232741
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0391 can be found here:
2024-09-18 - Revision of a currently approved collection
2024-07-09 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
4a_2019 NSECE Home-based Provider Screener and Questionnaire (clean copy).docx
Other-Screener and Quesionnaire
4a_2019 NSECE Home-based Provider Screener and Questionnaire (clean)_051419.docx
Other-SUMMER Screener & Questionnair
4a_2019 NSECE Home-based Provider Screener and Questionnaire (tracking copy).docx
Revised Home-based Provider Screener and Questionnaire - Tracked Version - Nonsub Change Req Dec 2018
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Home-based provider QUESTIONNAIRE WITH SCREENER (listed home-based providers)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Screener and Quesionnaire
4a_2019 NSECE Home-based Provider Screener and Questionnaire (clean copy).docx
Yes
Yes
Fillable Fileable
Other-SUMMER Screener & Questionnaire
4a_2019 NSECE Home-based Provider Screener and Questionnaire (clean)_051419.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,000
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
4,000
0
0
0
0
4,000
Annual IC Time Burden (Hours)
2,680
0
0
0
0
2,680
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Revised Home-based Provider Screener and Questionnaire - Tracked Version - Nonsub Change Req Dec 2018
4a_2019 NSECE Home-based Provider Screener and Questionnaire (tracking copy).docx
12/06/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.